Novel advancements in threedimensional neural tissue engineering and regenerative medicine

Neurological diseases and injuries present some of the great- est challenges in modern medicine, often causing irrevers- ible and lifelong burdens in the people whom they afflict. Conditions of stroke, traumatic brain injury, spinal cord injury, and neurodegenerative diseases have devastating con- sequences on millions of people each year, and yet there are currently no therapies or interventions that can repair the structure of neural circuits and restore neural tissue function in the brain and spinal cord. Despite the challenges of over- coming these limitations, there are many new approaches under development that hold much promise. Neural tissue engineering aims to restore and influence the function of damaged or diseased neural tissue generally through the use of stem cells and biomaterials. Many types of biomaterials may be implemented in various designs to influence the survival, differentiation, and function of developing stem cells, as well as to guide neurite extension and morphological architecture of cell cultures. Such designs may aim to reca- pitulate the cellular interactions, extracellular matrix char- acteristics, biochemical factors, and sequences of events that occur in neurodevelopment, in addition to supporting cell survival, differentiation, and integration into innate neural tissue.

Femtosecond laser small incision lenticule extraction on binocularity for myopia with glasses-free 3D technique

AIM:To evaluate the effect of femtosecond laser small incision lenticule extraction(SMILE)on the binocular visual function in myopic patients with glasses-free threedimensional(3D)technique.METHODS:Totally 50 myopic patients(39 females and 11 males)with SMILE were enrolled in this prospective study.The glasses-free 3D technique was used to evaluate the binocular visual function in these subjects including static stereopsis,dynamic stereopsis,foveal suppression,and binocular balance point of signal to noise ratio(s/n ratio).All subjects received measurements in 1d before operation,and 1d,1wk,and 1mo postoperatively.RESULTS:Both static and dynamic stereopsis showed no significant difference after SMILE.The foveal suppression improved significantly 1wk and 1mo after SMILE(P=0.005 and P=0.007 respectively).The binocular balance point of signal to noise ratio showed a significant improvement 1d,1wk and 1mo after SMILE for both eyes(P<0.001 for each eye respectively).CONCLUSION:Glasses-free 3D technique can be used to evaluate the effect of SMILE on the binocular visual function in myopic patients perceptively,and SMILE can improve both foveal suppression and binocular imbalance in these patients.

Usefulness of three-dimensional visualization technology in minimally invasive treatment for infected necrotizing pancreatitis

AIM To explore the value of three-dimensional(3 D) visualization technology in the minimally invasive treatment for infected necrotizing pancreatitis(INP). METHODS Clinical data of 18 patients with INP, who were admitted to the PLA General Hospital in 2017, were retrospectively analyzed. Two-dimensional images of computed tomography were converted into 3 D images based on 3 D visualization technology. The size, number, shape and position of lesions and their relationship with major abdominal vasculature were well displayed. Also, percutaneous catheter drainage(PCD) number and puncture paths were designed through virtual surgery(percutaneous nephroscopic necrosectomy) based on the principle of maximum removal of infected necrosis conveniently.RESULTS Abdominal 3 D visualization images of all the patients were well reconstructed, and the optimal PCD puncture paths were well designed. Infected necrosis was conveniently removed in abundance using a nephroscope during the following surgery, and the median operation time was 102(102 ± 20.7) min. Only 1 patient underwent endoscopic necrosectomy because of residual necrosis. CONCLUSION The 3 D visualization technology could optimize the PCD puncture paths, improving the drainage effect in patients with INP. Moreover, it significantly increased the efficiency of necrosectomy through the rigid nephroscope. As a result, it decreased operation times and improved the prognosis.

Three-dimensional image of hepatocellular carcinoma under confocal laser scanning microscope

AIM To investigate the application of confocallaser scanning microscopy(CLSM)in tumorpathology and three-dimensional( 3-D )reconstruction by CLSM in pathologic specimensof hepatocellular carcinoma(HCC).METHODS The 30μm thick sections were cutfrom the paraffin-embedded tissues of HCC,hyperplasia and normal liver,stained with DNAfluorescent probe YOYO-1 iodide and examinedby CLSM to collect optical sections of nuclei and3-D images reconstructed.RESULTS HCC displayed chaotic arrangementof carcinoma cell nuclei,marked pleomorphism,indented and irregular nuclear surface,andirregular and coarse chromatin texture.CONCLUSION The serial optical tomograms ofCLSM can be used to create 3-D reconstruction ofcancer cell nuclei.Such 3-D impressions mightbe helpful or even essential in making anaccurate diagnosis.

Study on the Relation between the Air Gap Size under Clothing and the Comfort Sensations

Combining two non-contact testing instruments of a three-dimensional body measure system and an infrared camera, the entrapped air gap under clothing and the clothing surface temperature distribution were measured without interfering the air gap state. It was discussed the effect of different air gap size on subjective clothing sensation. At the same time, taken the subjective sensations of moisture, adhesiveness and mugginess from the lower back as example, the relationship among the subjective evaluation, the air gap size and the clothing surface temperature were analyzed.

Evaluation of 4 three-dimensional representation algorithms in capsule endoscopy images

AIM:To evaluate the three-dimensional(3-D)representation performance of 4 publicly available Shapefrom-Shading(SfS)algorithms in small-bowel capsule endoscopy(SBCE).METHODS:SfS techniques recover the shape of objects using the gradual variation of shading.There are4 publicly available SfS algorithms.To the best of our knowledge,no comparative study with images obtained during clinical SBCE has been performed to date.Three experienced reviewers were asked to evaluate 54 twodimensional(2-D)images(categories:protrusion/inflammation/vascular)transformed to 3-D by the aforementioned SfS 3-D algorithms.The best algorithm was selected and inter-rater agreement was calculated.RESULTS:Four publicly available SfS algorithms were compared.Tsai’s SfS algorithm outperformed the rest(selected as best performing in 45/54 SBCE images),followed by Ciuti’s algorithm(best performing in 7/54images)and Torre o’s(in 1/54 images).In 26/54 images;Tsai’s algorithm was unanimously selected as the best performing 3-D representation SfS software.Tsai’s 3-D algorithm superiority was independent of lesion category(protrusion/inflammatory/vascular;P=0.678)and/or CE system used to obtain the 2-D images(MiroCam/PillCam;P=0.558).Lastly,the interobserver agreement was good(kappa=0.55).CONCLUSION:3-D representation software offers a plausible alternative for 3-D representation of conventional capsule endoscopy images(until optics technology matures enough to allow hardware enabled-"real"3-D reconstruction of the gastrointestinal tract).

Organoids of liver diseases: From bench to bedside

Understanding the occurrence, development, and treatment of liver diseases is the main goal of hepatopathology research. Liver diseases are not only diverse but also highly heterogeneous among individuals. At present, research on liver diseases is conducted mainly through cell culture, animal models, pathological specimens, etc. However, these methods cannot fully reveal the pathogenic mechanism and therapeutic characteristics of individualized liver diseases.Recent advances in three-dimensional cell culture technology(organoid culture techniques) include pluripotent stem cells and adult stem cells that are cultured in vitro to form self-organizing properties, making it possible to achieve individualized liver disease research. This review provides a comprehensive overview of the development of liver organoids, the existing and potential applications of liver regenerative medicine, the pathogenesis of liver disease heterogeneity, and drug screening.

Mixed reality for visualization of orthopedic surgical anatomy

In the modern era,preoperative planning is substantially facilitated by artificial reality technologies,which permit a better understanding of patient anatomy,thus increasing the safety and accuracy of surgical interventions.In the field of orthopedic surgery,the increase in safety and accuracy improves treatment quality and orthopedic patient outcomes.Artificial reality technologies,which include virtual reality(VR),augmented reality(AR),and mixed reality(MR),use digital images obtained from computed tomography or magnetic resonance imaging.VR replaces the user’s physical environment with one that is computer generated.AR and MR have been defined as technologies that permit the fusing of the physical with the virtual environment,enabling the user to interact with both physical and virtual objects.MR has been defined as a technology that,in contrast to AR,enables users to visualize the depth and perspective of the virtual models.We aimed to shed light on the role that MR can play in the visualization of orthopedic surgical anatomy.The literature suggests that MR could be a valuable tool in orthopedic surgeon’s hands for visualization of the anatomy.However,we remark that confusion exists in the literature concerning the characteristics of MR.Thus,a more clear description of MR is needed in orthopedic research,so that the potential of this technology can be more deeply understood.

Observation and measurement of applied anatomical features for thoracic intervertebral foramen puncture on computed tomography images

BACKGROUND Thoracic intervertebral foramen puncture is the key step for interventional therapy on the thoracic nerve roots or dorsal root ganglia.The anatomical features of the thoracic spine are complex,and puncture injury to the pleura,blood vessels,spinal cord,and other tissues may cause serious complications.The spatial anatomical characteristics and related parameters for thoracic intervertebral foramen puncture remain poorly understood.AIM To observe and summarize the spatially applied anatomical characteristics for intervertebral foramen puncture on different vertebral segments.METHODS A total of 88 patients(41 males and 47 females)who underwent thoracic minimally invasive interventional treatment at Nanjing Drum Tower Hospital from January 2019 to June 2020 were included.Computed tomography images of 167 thoracic vertebral segments scanned in the prone position were collected.The width of the intertransverse space(D_(P)),the height of the rib neck/head above the lower transverse process(D_(R)),the width of the lateral border of the articular process/lamina(W_(P)),and the width of the posterior border of the vertebral body(W_(V))were measured.At the upper 1/3 of the intervertebral foramina,the horizontal inclination angle(α)from the lateral border of the articular process/lamina to the posterolateral border of the vertebral body was measured.The ratios D_(R)/D_(P) and W_(P)/W_(V) were calculated.The intervertebral foramen parameters were compared between segments.RESULTS No rib head/neck occlusion(D_(R)/D_(P)>0)was found in the intertransverse spaces of T1-2 and T12-L1.The incidence of occlusion for the upper thoracic segments(T1-5,n=138),middle thoracic segments(T5-9,n=116),and lower thoracic segments(T9-L1,n=80)were 76.81%,100%,and 82.50%,respectively.The incidence of occlusion for the middle thoracic segments was significantly higher than that for the upper and lower thoracic segments(P<0.05).The incidence of>1/2 occlusion(D_(R)/D_(P)>1/2)for the upper,middle,and lower thoracic segments was 7.97%,74.14%,and 32.50%,respectively.The incidence of>1/2 occlusion for the middle thoracic segments was significantly higher than that for the upper and lower thoracic segments(P<0.05).W_(P) was longer than W_(V) on T1-2 to T9-10 and shorter than W_(V) on T10-11 to T12-L1.The horizontal puncture angle(α)into the external opening of the intervertebral foramina was positively correlated with the segments of the thoracic vertebrae from the cephalic to caudal portion(left:r=0.772,P<0.01;right:r=0.771,P<0.01),and the horizontal inclination angle for T11-12 and T12-L1 was 90°.CONCLUSION It is necessary to identify the spatial impact of the rib head/neck on the puncture path of the intervertebral foramina and design appropriate puncture angles for different segments.

The application of geographic information technology to coastal geomorphology

With the development of modern oceanic observation technologies, coastal survey data have been experiencing a substantial growth. The integration management of the data from different disciplines, different sources and different formats has become a major research field in coastal geomorphology by using Geographic Information System （GIS）. This paper puts forward a new methodology framework of GIS techniques in coastal ocean geomorphology, including data acquisition, process, analysis, and representation. It focuses on some major GIS techniques to study the land-ocean interaction mechanism, such as spatial analysis, submarine topography model and three-dimension （3D） visualization, and apply its result to coastal urban planning, harbor site selection and geomorphology environment about coral reef and islands on the continental shelf. The case studies cover the whole coastal ocean to serve the social community, economical development and diplomatic rights for decision-making all round in the coastal zone. The research shows clearly that the application of coastal multi-source geospatial platform has changed the traditional coastal geomorphology science dramatically from its research scope, fields and methods, however, as made clear in this paper, extracting accurate information from remote sensing data and GIS databases for coastal geomorphological applications is a nontrivial challenge that requires the combined knowledge and skills of information scientists and geomorphologists.

Rare location and drainage pattern of right pulmonary veins and aberrant right upper lobe bronchial branch: A case report

BACKGROUND Complex aberration in lung is rare,which may increase risk of vascular injury and cause ligation of wrong pulmonary vein or bronchus by mistake during lung surgery,and result in sever complication like pulmonary congestion or atelectasis.CASE SUMMARY A 44-year-old female was admitted for a ground glass nodule(24 mm in diameter)in her right upper lobe.Video-assisted thoracoscopic(VATS)right upper lobectomy with lymph nodes dissection was performed.During operation,we simultaneously identified extremely rare aberrations of right preeparterial bronchus,right upper lobe vein behind pulmonary artery and right middle lobe vein drained into left atrium in this patient.The patient was well recovered and discharged at the postoperative-day 4.CONCLUSION Preoperatively,three-dimensional reconstruction can help to identify inconspicuous variation of pulmonary vessels and bronchus effectively.During lung surgery,if anatomic aberration is suspected,careful dissection of vessels and bronchus will help to confirm whether there is an aberration or not.

Clinical Research on Three-Dimensional Conformal Radiotherapy of Non-Small Cell Lung Cancer

OBJECTIVE To investigate the clinical efficacy and toxic effect of the 3-dimensional conformal radiation therapy （3DCRT） for non- small cell lung cancer （NSCLC）. METHODS Fifty-two patients with the Stage-I and IV NSCLC were treated with 3DCRT. Cross analysis of the clinical data was conducted in the comparison between the 52 cases with 3DCRT and the other 50 cases with the conventional radiation therapy （CRT）. In the 3DCRT group, only the primary tumor and positive lymph-node draining area were included in the clinical target area, setting 4 to 6 coplanar or non-coplanar irradiation fields, with 2 Gy or 3 Gy/fraction, 1 fraction a day and 5 fractions per week. The total dose ranged from a test dose （DT） of 66 Gy to 72 Gy. In the CRT group, the field area contained the primary tumor plus the homolateral hilum of the lung, the mediastinum superior or hol-mediastinum, and opposed anteroposterior irradiation. When the dosage reached DT 36-40 Gy, an oblique portal administered radiation was conducted in order to avoid injuring the spinal cord. The DT was 1.8-2.0 Gy/fraction, 1 fraction a day, 5 fractions per week, with a total dose of 60 Gy to 70 Gy. RESULTS The therapeutic effect （CR ＋ PR） was 90.4% in the 3DCRT group, and was 72% in the CRT group. There was statistically significant difference between the two groups, P 〈 0.01. There was a clinical symptom improvement attained by 96.5% and 86.4% respectively in the two groups, and there was a statistically significant difference between the groups, P 〈 0.01. The 6-month, 1 and 2-year overall survival rates were 92.3%, 75.0% and 42.3% in the 3DCRT group, and 76%, 60% and 30% in the CRT group, respectively. There was a significant difference in the 6-month overall survival rate between the groups, P 〈 0.05. There was no obvious significant difference in the 1 and 2-year overall survival rates between the two groups, P 〉 0.05. The toxic reaction was 12.5% and 23.7% respectively in the 3DCRT and CRT groups. Acute radioactive esophagitis and leucopenia were markedly lower in the 3DCRT group than in the CRT group. There was a statistically significant difference between the groups, P 〈 0.05. No toxic reaction of Stage-III and over was found in the 3DCRT group during radiation therapy. CONCLUSION The 3DCRT method has a satisfactory shortterm efficacy and improvement of clinical symptoms in treating NSCLC, with a mild toxic reaction and good tolerance in patients. It can be used for enhancing the tumor-control rate and bettering the quality of life.

Simulation of Dynamic 3D Crack Propagation within the Material Point Method

This paper presents the principles and algorithms for simulation of dynamic crack propagation in elastic bodies by the material point method(MPM),from relatively simple two-dimensional cases to full three-dimensional,mixed-mode crack propagation.The paper is intended to give a summary of the latest achievements on simulation of three-dimensional dynamic crack propagation,which is essentially an unexplored area.Application of the methodology presented in this paper to several dynamic crack propagation problems has shown that the MPM is a reliable and powerful approach for simulating three-dimensional,mixed-mode crack propagation.

A Virtual Boundary Element Method for Three-Dimensional Inverse Heat Conduction Problems in Orthotropic Media

This paper aims to apply a virtual boundary element method(VBEM)to solve the inverse problems of three-dimensional heat conduction in orthotropic media.This method avoids the singular integrations in the conventional boundary element method,and can be treated as a potential approach for solving the inverse problems of the heat conduction owing to the boundary-only discretization and semi-analytical algorithm.When the VBEM is applied to the inverse problems,the numerical instability may occur if a virtual boundary is not properly chosen.The method encounters a highly illconditioned matrix for the larger distance between the physical boundary and the virtual boundary,and otherwise is hard to avoid the singularity of the source point.Thus,it must adopt an appropriate regularization method to deal with the ill-posed systems of inverse problems.In this study,the VBEM and different regularization techniques are combined to model the inverse problem of three-dimensional heat conduction in orthotropic media.The proper regularization techniques not only make the virtual boundary to be allocated freer,but also solve the ill-conditioned equation of the inverse problem.Numerical examples demonstrate that the proposed method is efficient,accurate and numerically stable for solving the inverse problems of three-dimensional heat conduction in orthotropic media.

Endovascular stent graft repair of abdominal aortic aneurysms:Current status and future directions

Endovascular stent graft repair of abdominal aortic aneurysm(AAA)has undergone rapid developments since it was introduced in the early 1990s.Two main types of aortic stent grafts have been developed and are currently being used in clinical practice to deal with patients with complicated or unsuitable aneurysm necks,namely,suprarenal and fenestrated stent grafts.Helical computed tomography angiography has been widely recognized as the method of choice for both pre-operative planning and post-operative followup of endovascular repair(EVAR).In addition to 2D axial images,a number of 2D and 3D reconstructions are generated to provide additional information about imaging of the stent grafts in relation to the aortic aneurysm diameter and extent,encroachment of stent wires to the renal artery ostium and position of the fenestrated vessel stents.The purpose of this article is to provide an overview of applications of EVAR of AAA and diagnostic applications of 2D and 3D image visualizations in the assessment of treatment outcomes of EVAR.Interference of stent wires with renal blood flow from the hemodynamic point of view will also be discussed,and future directions explored.

A modified 3D stereophotogrammetry-based distraction test for assessing lower eyelid tension

AIM: To investigate the reliability of a modified threedimensional distraction test(3D-DT) and three-dimensional pinch test(3D-PT) for assessing lower eyelid tension(LET).METHODS: A cross-sectional study was conducted among 97 volunteer s including 97 eyelids with no history of trauma, tumor, or reconstructive surgeries. Six three-dimensional photographs were acquired for each par ticipant, including two photographs obtained in a neutral position(NP), two using a modified 3D-DT with a 15.9-grammes stainless steel eyelid hook performed, and two using 3D-PT.RESULTS: The mean absolute differences between NP, 3D-DT, and 3D-PT measurements varied between 0.07 and 7.42, 0.10 and 13.10, and 0.07 and 15.97, respectively;technical error of measurement varied between 0.05 and 7.81, 0.09 and 10.19, and 0.07 and 12.47, respectively;and relative error measurements varied between 0.10% and 11.50%, 0.16% and 30.51%, and 0.11% and 38.75%, respectively. For intra-rater reliability, the intraclass correlation coefficients(ICCs) were more than 0.80 in seven out of eight measurements obtained in the NP and 3D-DT, whereas those obtained in the 3D-PT were as low as less than 0.30 by rater 1;the ICCs of all the measurements obtained in all the positions(NP, 3D-DT, and 3D-PT) were more than 0.80 by rater 2. For inter-rater reliability six out of eight NP and 3D-DT measurements had an ICC greater than 0.80, whereas those of 3D-PT measurements were less than 0.30. For intra-method reliability, the ICCs of all the NP measurements were more than 0.87, whereas those of the six 3D-DT measurements and four 3D-PT measurements were more than 0.80.CONCLUSION: Our study results prove that the modified 3D-DT, which involves the use of an eyelid hook, can be a highly reliable method for evaluating LET. Furthermore, this novel and simple method may be utilized as the basis for further investigation and routine pre-and postoperative clinical evaluation.

Three-dimensional radiation dosimetry using polymer gel and solid radiochromic polymer: From basics to clinical applications

Accurate dose measurement tools are needed to evaluate the radiation dose delivered to patients by using modern and sophisticated radiation therapy techniques. However, the adequate tools which enable us to directly measure the dose distributions in threedimensional(3D) space are not commonly available. One such 3D dose measurement device is the polymerbased dosimeter, which changes the material property in response to radiation. These are available in the gel form as polymer gel dosimeter(PGD) and ferrous gel dosimeter(FGD) and in the solid form as solid plastic dosimeter(SPD). Those are made of a continuous uniform medium which polymerizes upon irradiation. Hence, the intrinsic spatial resolution of those dosimeters is very high, and it is only limited by the method by which one converts the dose information recorded by the medium to the absorbed dose. The current standard methods of the dose quantification are magnetic resonance imaging, optical computed tomography, and X-ray computed tomography. In particular, magnetic resonance imaging is well established as a method for obtaining clinically relevant dosimetric data by PGD and FGD. Despite the likely possibility of doing 3D dosimetry by PGD, FGD or SPD, the tools are still lacking wider usages for clinical applications. In this review article, we summarize the current status of PGD, FGD, and SPD and discuss the issue faced by these for wider acceptance in radiation oncology clinic and propose some directions for future development.

Technical analysis of 3DTV and outstanding issues

This paper analyzes the technical characteristic of three-dimensional display technology （3DTV） system and some core technologies yet to be solved. It points out the ways to solve these problems and presents an effective solution for thediscomfort of watching the three-dimensional TV.

2D Coupled 3D:A New Numerical Model for Dual - Structured - Aquifer System

This paper points out that a successful numerical simulation is to construct a correct conceptional model which is very dose to the natural condition. A new model, two dimensional coupled three dimensional model (2D -3D ) is presented in the Present paper,which is the most suitable one for the dual - structured - aquifer system. An example of Wenyinghu area is shown.By using the 2D-3D model, a satisfied result of the simulated area is achieved.

Clinical and molecular characterization of 10 Chinese children with congenital adrenal hyperplasia due to 11beta‑hydroxylase deficiency

Background The clinical manifestations of nonclassical 11beta-hydroxylase deficiency are very similar to those of nonclassical 21-hydroxylase deficiency.For this study,we investigated the relationship between the clinical and molecular features of congenital adrenal hyperplasia caused by 11beta-hydroxylase deficiency and reviewed the related literature,which are expected to provide assistance for the clinical diagnosis and analysis of congenital adrenal hyperplasia.Methods Clinical data for 10 Chinese patients diagnosed with congenital adrenal hyperplasia in our hospital from 2018 to 2022 were retrospectively analyzed.We examined the effects of gene mutations on protease activity and constructed threedimensional structure prediction models of proteins.Results We describe 10 patients with 11beta-hydroxylase gene mutations(n=5,46,XY;n=5,46,XX),with 10 novel mutations were reported.Female patients received treatment at an early stage,with an average age of 2.08±1.66 years,whereas male patients received treatment significantly later,at an average age of 9.77±3.62 years.The most common CYP11B1 pathogenic variant in the Chinese population was found to be c.1360C>T.All mutations lead to spatial conformational changes that affect protein stability.Conclusions Our study found that there was no significant correlation between each specific mutation and the severity of clinical manifestations.Different patients with the same gene pathogenic variant may have mild or severe clinical manifestations.The correlation between genotype and phenotype needs further study.Three-dimensional protein simulations may provide additional support for the physiopathological mechanism of genetic mutations.